Deck 17: Drugs for Psychoses

Question 1

The nurse has completed medication education with the patient who is receiving clozapine (Clozaril).The nurse evaluates that the education has been effective when the patient makes which statement?
1)"I must call my doctor if I start to have a lot of nightmares."
2)"I must have my blood work done while taking this medication."
3)"I must call my doctor if I start to lose a lot of weight."
4)"I must call my doctor if I notice any unusual bruising."

Answer 1

2

Question 2

Which of the following would be the most appropriate action while treating a patient who overdosed on risperidone (Risperdal)20 minutes ago?
1)Administer a CNS depressant.
2)Administer an anticholinergic.
3)Administer activated charcoal.
4)Symptom management is the only indicated treatment.

Answer 2

3

Question 3

Symptoms of schizophrenia are thought to be associated with which receptor sites?
1)Dopamine type 2
2)Adrenergic
3)Beta 2
4)Cholinergic

Answer 3

1

Question 4

An elderly female psychotic patient has been taking haloperidol (Haldol)for 1 week.The patient has been making wormlike movements with her tongue.The nurse identifies this to most likely be
1)an adverse effect likely caused by the medication,known as tardive dyskinesia.
2)a normal reaction to the medication that will likely go away in a week or two.
3)a sign that the patient has not been taking the medication.
4)a sign of the patient's underlying psychosis,indicating that the medication is not effective.

Question 5

The patient is receiving clozapine (Clozaril).What is a priority outcome for this patient?
1)The patient reports any narrowing of the field of vision.
2)The patient reports any joint pain or swelling.
3)The patient reports any signs of a sore throat or an infection.
4)The patient reports any yellowish halos around lights.

Question 6

The patient receives quetiapine (Seroquel)and asks the nurse how the medication works.What is the best response by the nurse?
1)"Quetiapine (Seroquel)decreases norepinephrine in your brain and that decreases your auditory hallucinations."
2)"Quetiapine (Seroquel)increases norepinephrine in your brain and that decreases your feelings of depression."
3)"Quetiapine (Seroquel)decreases dopamine in your brain and that decreases your symptoms."
4)"Quetiapine (Seroquel)increases dopamine in your brain and that helps you to think more clearly."

Question 7

The patient has been receiving chlorpromazine (Thorazine)for the treatment of schizophrenia.The nurse assesses that the patient has tardive dyskinesia.What describes the result of the nurse's assessment?
1)Tremor,muscle rigidity,and a shuffling gait
2)Severe muscle spasms of the back,neck,and tongue
3)An inability to rest or relax,and restlessness
4)Unusual facial movements and lip smacking

Question 8

A patient experiencing an extrapyramidal adverse effect is not able to relax.This is known as
1)dystonia.
2)tardive dyskinesia.
3)akathisia.
4)Parkinsonism.

Question 9

The patient with schizophrenia is sitting quietly in a chair.The patient does not respond much to what is happening,and has a lack of interest in the environment.What best describes the result of the nurse's assessment?
1)The patient is most likely very depressed.
2)The patient is most likely hearing voices.
3)The patient is experiencing positive symptoms.
4)The patient is experiencing negative symptoms.

Question 10

The patient has been admitted to the hospital for the treatment of schizophrenia.The patient's mother says to the nurse,"This is all so confusing.How did he get this? Did I do something?" What is (are)the best response(s)of the nurse? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Schizophrenia is a biological brain disorder."
2)"Schizophrenia is linked to drinking alcohol during pregnancy."
3)"Research indicates that a very stressful environment causes schizophrenia."
4)"Research indicates that schizophrenia is a genetic disorder."
5)"Schizophrenia is due to too much dopamine in certain parts of the brain."

Question 11

The nurse has completed diet education for a group of patients who are receiving antipsychotic medications.If the medication education has been effective,patients will eliminate what choice from their menu selection?
1)Meats with a high-fat content
2)Beverages with caffeine
3)Refined breads and desserts
4)Shellfish and peanuts

Question 12

Which of the following drugs would be indicated for a schizophrenic who needs management of both positive and negative symptoms?
1)Thioridazine HCL (Mellaril)
2)Haloperidol (Haldol)
3)Clozapine (Clozaril)
4)Chlorpromazine (Thorazine)

Question 13

A patient with a psychiatric history is communicating using made-up words,and indicates he doesn't care about anything.This patient would most likely be
1)demonstrating symptoms of depression.
2)demonstrating positive symptoms of schizophrenia.
3)demonstrating negative symptoms of schizophrenia.
4)demonstrating symptoms of bipolar disorder.

Question 14

The patient is receiving antipsychotic medications and tells the nurse he has not had a bowel movement for 2 days.What is the best initial action of the nurse?
1)Hold the medication until the patient has a bowel movement.
2)Have the patient drink prune juice and additional fluids.
3)Contact the physician for an order for a Fleet Enema.
4)Contact the physician for an order for a stool softener.

Question 15

The nurse is managing the care of a group of patients with schizophrenia.The patients are receiving conventional antipsychotic medications.When assessing for anticholinergic side effects,which would the nurse immediately report to the physician?
1)Acute dystonia
2)Complaint of a severe headache
3)Hypertension
4)Urinary retention

Question 16

The relapse rate for psychotic patients who are not compliant and discontinue their medications is
1)60-80%.
2)50-70%.
3)30-40%.
4)20-50%.

Question 17

The patient who is receiving antipsychotic medication complains of having a dry mouth.The patient refused the morning dose of the medication.What is the best response by the nurse?
1)"Why are you refusing the medicine?"
2)"I can give you benztropine (Cogentin)for your dry mouth."
3)"I will let your doctor know about your dry mouth."
4)"A dry mouth is common,but drinking more water will help."

Question 18

The physician has prescribed haloperidol (Haldol)for the patient with schizophrenia.What is the priority patient outcome?
1)The patient will consume adequate fluids and a high-fiber diet.
2)The patient will be compliant with taking the medication as prescribed.
3)The patient will report a decrease in auditory hallucinations.
4)The patient will report symptoms of restlessness.

Question 19

The patient is receiving clozaril (Clozapine)for the treatment of schizophrenia.The nurse evaluates the effectiveness of this medication when the patient makes which statement?
1)"I will start going to group therapy."
2)"I think I am ready for discharge,as I feel better."
3)"I am not hearing the voices anymore."
4)"I promise not to skip breakfast anymore."

Question 20

The patient is receiving risperidone (Risperdal).During morning assessment,the nurse notes that the patient has a temperature of 102 degrees F.What is the priority nursing intervention?
1)Contact the physician,as this could be a symptom of neuroleptic malignant syndrome.
2)Contact the physician,as this could be a symptom of an acute urinary infection.
3)Contact the physician,as this could be a symptom of a bacterial pneumonia.
4)Contact the physician,as this could be a symptom of extrapyramidal side effects.

Question 21

During an assessment,the nurse determines a patient is demonstrating symptoms of a psychosis.What did the nurse assess in this patient? Credit will be given only if all correct choices and no incorrect choices are selected.
1)The patient says,"The servants need to be disciplined."
2)The patient says,"The voice told me to cut myself."
3)The patient laughs when asked about the health of a family member hospitalized for cancer treatment.
4)The patient asks to close the room door so "that man can't get to me."
5)The patient says,"I have not been able to get any sleep for months."

Question 22

A patient with a history of suicidal behavior with schizophrenia stopped taking clozapine (Clozaril)after 4 weeks of therapy.The patient is currently experiencing a return of hallucinations.What might the nurse assess when determining the reason the patient stopped taking the medication? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Feeling sedated all the time
2)Significant weight gain
3)Agitation
4)Fatigue and headache
5)Lack of desire to consume alcohol

Question 23

A patient taking aripiprazole (Abilify)for schizophrenia is experiencing signs of hypotension with certain activities since starting this medication.What should the nurse teach the patient? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Avoid being outside in the heat of the day.
2)Avoid hot baths or hot showers.
3)Avoid caffeine-containing preparations.
4)Change positions slowly,especially from lying or sitting to standing.
5)Take frequent naps during the day.

Question 24

While conducting a health history,the nurse notes that the patient is demonstrating positive signs of schizophrenia.What did the nurse assess in this patient? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Disorganized sentence structure
2)Kicking the nurse
3)Not responding to questions
4)Difficulty following instructions
5)Stating that God wants the patient to go home

Question 25

The nurse is performing the initial assessment on a patient admitted to the psychiatric unit.The patient hears voices saying to cut the patient's arms with razor blades until they bleed.The nurse should assess for Credit will be given only if all correct choices and no incorrect choices are selected.
1)family history of first-degree relative with schizophrenia.
2)use of illegal substances.
3)recent episodes of anxiety.
4)fFamily history of heart disease.
5)hHistory of a dysfunctional family.

Question 26

The nurse suspects a patient is demonstrating negative symptoms of schizophrenia and will be a challenge to treat because of which barriers? Credit will be given only if all correct choices and no incorrect choices are selected.
1)The patient feels that the symptoms are normal.
2)Family members feel the patient is going through a period of depression.
3)The patient is suspicious of the motives of the health care provider.
4)Family members have labeled the patient as lazy.
5)The patient is indifferent to obtaining help.

Question 27

The nurse is assessing a female patient who has been taking chlorpromazine for schizophrenia.What should the nurse include in this assessment? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Perform an eye exam and ask if there have been changes in vision.
2)Draw blood to check a lipid profile.
3)Ask the patient questions regarding amount of alcohol intake.
4)Determine the date of her last menstrual period.
5)Draw blood to check thyroid function.

Question 28

A patient who has been treated with antipsychotic agents for schizophrenia has an elevated blood pressure,dyspnea,and an extremely high temperature.This condition is known as
1)akathisia.
2)extrapyramidal side effects.
3)acute dystonias.
4)neuroleptic malignant syndrome.